Last reviewed 29 July 2021
Should mental health first aid training become law? Laura King considers whether training can exist in isolation and how organisations can incorporate it into wider mental health support.
On 21 March 2021, Dean Russell MP, introduced a new Bill that would make mental health first aid (MHFA) training a requirement in every workplace. Introduced under the 10-minute rule, Russell told the House of Commons that MHFA should be given the same level of importance as first-aid training for injuries, arguing that: “Whilst we are well on our way to defeating the virus, we are likely to emerge on the other side of the pandemic with another crisis of public health, but one of mental health, not physical”.
Although Bills introduced through the 10-minute rule rarely make the statue book, they can be an important way for MPs to raise awareness for causes that they feel are important. And, while the importance of good mental health was already gaining awareness in workplaces pre-pandemic, the negative effects of Covid-19 on the nation’s mental health are becoming harder to ignore.
Mental health has deteriorated during the pandemic
As a nation, our mental health is clearly suffering — and illnesses such as Covid-19 Anxiety Syndrome and Long Covid mean that we are not out of the woods yet. For example, the latest Office for National Statistics (ONS) data shows that levels of depression between January and March 2021 are more than double that observed before the Covid-19 pandemic began, and one study shows that up to 20% of people are struggling to disengage from Covid-19 threats. Of those that have been diagnosed with Covid-19, a study in the Lancet found that survivors are at a greater risk of mental health problems in the three months after diagnosis, and symptoms of Long Covid — which is now thought to affect a third of people who had suspected or confirmed Covid-19 — includes depression and anxiety.
What is the business cost of poor mental health?
The impact of poor mental health on workplaces has long been understood. ONS data for sickness absence shows that mental health conditions (including stress, anxiety, depression, as well as serious mental health problems) are consistently within the top four reasons for absence. The 2018 Labour Force Survey found that stress, depression and anxiety accounted for 17.9 million days lost due to work-related ill-health in 2019/20.
This comes at a cost. According to the Stevenson/Farmer Review on mental health in the workplace, the bill to UK businesses is in the region of £25 to 34 billion each year, with a further £8 billion resulting from staff turnover. Worse still, many employers are not fully aware of the impact of mental health problems within their workplace. For example, some studies have suggested that although mental health issues are a core reason for taking a day’s leave, 90% of people will provide another explanation. Business in the Community’s 2019 report showed that less than 50% of people (44%) would feel comfortable talking to their line manager about their mental health and although the 2020 report found that the way organisations were responding to mental health had improved, there was still a rise in the number of people who were not telling anyone about their mental health issues.
What is mental health first aid?
MHFA training is designed to help participants understand what mental health is, what good mental health looks like, and what factors can affect it. It provides practical skills to identify signs of mental illness, as well as strategies and the confidence to help someone — both in a crisis and in terms of able to provide support and to signpost people to further help.
It is important to note that, in the same way that physical first-aid courses do not expect an individual to offer the same support as a paramedic or doctor, mental health first aiders are not expected to act as therapists or provide ongoing support. Instead, they can act as a point of contact, to listen, provide reassurance, let employees know what professional help is available, and can also act as ambassadors for mental health in the workplace.
What benefits does MHFA training provide?
Rising cases of poor mental health, along with the difficulties that people face in reporting any problems they are having, are two reasons why MHFA training could be seen as a positive step. And indeed, improving awareness is one way in which the training has been shown to be effective.
For example, in 2021, the Health and Safety Executive (HSE) published a summary of the effectiveness of MHFA training. Gaps in the evidence base were significant — but the authors found that MHFA training did improve awareness of conditions, signs and symptoms. However, there was limited evidence demonstrating that training led to better organisational management of mental health, or that the training led to a sustained ability of those trained to help colleagues. Although gaps in the knowledge base are part of the reason for this, a lack of a clear link would not, in itself, be unsurprising.
To be effective, MHFA training needs to exist within a hierarchy of measures and within a culture where mental health is supported. No organisation would train first aiders as the only way to create a safe workplace; similarly, having a trained metal health first aider cannot be the only way in which an organisation supports the mental health of its employees.
What needs to be included to make MHFA successful?
There are several elements that an organisation needs to consider alongside training. These include the following.
Leadership: does the organisation have a clear commitment from senior management to tackle mental health within the organisation?
Attitude: are risks to mental health given high enough priority? Here, an organisation needs to be clear on what its legal responsibilities are, the reasons why mental health is important, and its overarching objectives.
Policy and plans: does the organisation have a policy and plan to build mental wellness within the organisation? Is it clear how any plan links all relevant policies (such as those on bullying, conflict management, or working conditions)? Are there clear indicators of how the success of the work plan is being measured?
Conducting risk assessments: has the organisation conducted risk assessments outlining risks to mental health as well as opportunities to promote wellbeing and better mental health?
Communicating and managing common problems: are the mitigating actions identified within the risk assessment taking place? For example, are activities, tools and adaptations designed to improve resilience and mental wellbeing being promoted? Are they accessible?
Providing support: even with a good culture and framework of support, some people will still suffer from mental health problems. Here, MHFA training can be important in helping to spot the early warning signs, along with other measures such as well-considered return-to-work programmes.
Poor mental health is becoming increasingly common since the pandemic. As such, it is important that employers have a workplace strategy to prevent mental health problems and to support staff where needed. MHFA training is an important part of the picture but cannot exist in isolation. Other aspects that are required include:
support from management
a mental health and wellbeing policy and strategy
risk assessments and mitigating actions that take mental health into consideration
a framework of support for employees.
Your Croner-i Mental Health at Work, Stress at Work and Wellbeing topics, as well as government guidance (for example, the Stevenson/Farmer Thriving at Work recommendations, and the HSE guidance on managing stress) are good starting points.